Tamoxifen retinopathy

Bazvand, Fatemeh; Mahdizad, Zahra; Mohammadi, Nader; Shahi, Farhad; Mirghorbani, Masoud; Riazi-Esfahani, Hamid; Modjtahedi, Bobeck S.

doi:10.1016/j.survophthal.2023.02.003

Cited by 6 publications

(5 citation statements)

References 78 publications

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“…Other potential differential diagnoses may be tamoxifen retinopathy that may present with small and discrete white yellowish refractile elements in the retina. 19 The reduced a-wave amplitudes under DA conditions suggest a loss of rod function and the reduced 30 Hz flicker amplitude in the right eye suggest early cone involvement in this case. Further genetic analysis on siblings and parents were not possible, but there is no reported family history of eye disease or difficulties with night vision.…”

Section: Discussionmentioning

confidence: 70%

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Suspected case of benign familial fleck retina with functional loss

Constable,

Loh,

Grigg

2023

Clinical Case Reports

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Key Clinical MessageInherited retinal dystrophies typically affect vision in early childhood; however, this case highlights a late onset retinal dystrophy presenting in midlife and the need for extended visual electrophysiology testing to determine the etiology.AbstractA 53‐year‐old female was referred for visual electrophysiology following a routine optometric eye examination in which yellow flecks were noted in both fundi and the patient had reported a recent near accident whilst driving at night. There was no reported family history of eye disease. Retinal examination identified bilateral yellow punctate and irregularly shaped lesions throughout the posterior poles sparing the macula region. Fundus autofluorescence showed coinciding hyperfluorescence with the lesions and bilateral hypofluorescent crescents superior to the macular with corresponding retinal thinning. Visual fields and color vision were normal. ISCEV standard 20 min and extended 60‐min dark adapted electroretinograms were recorded. Recovery to normal b‐wave amplitudes was noted in the DA0.01 flash but reduced a‐wave amplitudes were noted in the DA3 and DA10 flash following both dark adapted periods. Cone function was reduced but within normal limits. Genetic screening revealed a previously unreported variant of unknown significance in the gene PLA2G5:c.40 + 5del (rs1364254561) which is a member of the phospholipase A2 family and is associated with familial benign flecked retina.

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Section: Discussionmentioning

confidence: 70%

“…Thus, this case is the first to report a novel mutation in an intronic region of PLA2G5 with clinical features of both fundus albipunctatus and FBFR. Other potential differential diagnoses may be tamoxifen retinopathy that may present with small and discrete white yellowish refractile elements in the retina 19 …”

Section: Discussionmentioning

confidence: 99%

Suspected case of benign familial fleck retina with functional loss

Constable,

Loh,

Grigg

2023

Clinical Case Reports

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“…Tamoxifen, a selective estrogen receptor modulator, has long been a cornerstone in the treatment of hormone receptor-positive breast cancer. 1,2 Its e cacy in reducing the risk of recurrence and mortality in breast cancer patients is well established. 3 However, the therapeutic bene ts of tamoxifen are not without potential ocular complications, particularly those affecting the macula.…”

Section: Introductionmentioning

confidence: 99%

“…3 However, the therapeutic bene ts of tamoxifen are not without potential ocular complications, particularly those affecting the macula. 1,2,[4][5][6][7] Recent studies have focused on the risk and associated factors of maculopathy, prompting the need for comprehensive investigations into the risk factors and incidence rates of ocular complications associated with this widely prescribed drug. 1,8 The ocular side effects of tamoxifen, speci cally tamoxifen-related retinopathy (maculopathy), have raised concerns among prescribing physicians and ophthalmologists.…”

Section: Introductionmentioning

confidence: 99%

“…Alterations in the retina are reported to manifest in approximately 12% of individuals who have been using a daily dose of 20 mg of tamoxifen for a period exceeding two years, 8 corresponding to a cumulative dose of approximately 15 g. These alterations include the presence of crystalline deposits, telangiectasia, hyperre ective deposits in the inner retinal layers, pseudocystic foveal cavitation, and cystoid macular edema. 1,2 Understanding the demographic and clinical characteristics of individuals at a higher risk of developing maculopathy is crucial for identifying preventive measures and optimizing patient care.…”

Section: Introductionmentioning

confidence: 99%

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Risk of Maculopathy in Tamoxifen Users: Drug Exposure and Risk Factors

Kwon,

Kim,

Ahn

2024

Preprint

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Tamoxifen, a pivotal therapy for hormone receptor-positive breast cancer, is known for its efficacy in reducing breast cancer recurrence and mortality. However, concerns about potential ocular complications, particularly maculopathy, have emerged. This study aims to investigate the risk and associated factors of diverse macular conditions in tamoxifen users, considering drug exposure, demographics, and systemic diseases. A nationwide cohort of tamoxifen users, comprised of 14,267 tamoxifen users, was analyzed using the Health Insurance Review and Assessment (HIRA) database in South Korea. Demographic and clinical characteristics were examined, and the cumulative incidence of macular diseases was stratified by age and cumulative tamoxifen dosage. Hazard ratios were calculated for risk factors, including age, sex, and systemic diseases affecting drug metabolism. Cumulative incidences of overall macular diseases, other maculopathy excluding common macular diseases, and macular edema were 26.4%, 11.4%, and 6.5%, respectively. The risk increased with age and cumulative tamoxifen dosage. Significant risk factors included age, sex, diabetes, hypertension, and kidney disease whereas dyslipidemia and liver disease showed no significant association with the macular conditions. Tamoxifen-induced maculopathy poses a concern for prescribing physicians and ophthalmologists, and this study provides valuable insights into its risk and risk factors. The complex interplay between age, cumulative tamoxifen dosage, and systemic diseases highlights the need for vigilant monitoring and screening strategies. This study may contribute to evidence-based guidelines for tamoxifen maculopathy screening, emphasizing the importance of considering multiple factors for recommendation on screening timing and frequency.

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